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(Investigative Ophthalmology and Visual Science. 2008;49:1172-1177.)
© 2008 by The Association for Research in Vision and Ophthalmology, Inc.
DOI:  10.1167/iovs.07-0636
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Confocal Blue Reflectance Imaging in Type 2 Idiopathic Macular Telangiectasia

Peter Charbel Issa,1 Tos T. J. M. Berendschot,2 Giovanni Staurenghi,3 Frank G. Holz,1 and Hendrik P. N. Scholl1

1From the Department of Ophthalmology, University of Bonn, Bonn, Germany; the 2University Eye Clinic Maastricht, Maastricht, The Netherlands; and the 3Eye Clinic Department of Clinical Science "Luigi Sacco," University of Milan, Milan, Italy.

PURPOSE. To report the characteristics of confocal blue reflectance imaging in type 2 idiopathic macular telangiectasia (type 2 IMT).

METHODS. In a prospective observational cross-sectional study, both eyes of 33 patients with type 2 IMT were examined by means of fundus biomicroscopy, fundus photography, fluorescein angiography, and optical coherence tomography (OCT). Confocal blue reflectance (CBR) imaging was performed using a confocal scanning laser ophthalmoscope (HRA2; Heidelberg Engineering, Heidelberg, Germany). To compare the results derived from different imaging modalities, an analysis was performed using image analysis software (Heidelberg Eye Explorer; Heidelberg Engineering).

RESULTS. CBR imaging revealed a parafoveal area of increased reflectance that was slightly larger than the area of hyperfluorescence in late-phase fluorescein angiography. The area usually encompassed an oval parafoveal area, but sectors could be spared. A parafoveal area of increased CBR was detected in 98% of eyes that showed angiographic evidence for type 2 IMT.

CONCLUSIONS. CBR imaging is a new, noninvasive, and sensitive method that may contribute to differentiate type 2 IMT from other diseases. Abnormalities of macular pigment distribution and Müller cell pathology may contribute to the phenomenon of increased CBR and thus the pathophysiology of type 2 IMT.






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